The Majorana Neutrinoless Double-Beta Decay Experiment

The proposed Majorana double-beta decay experiment is based on an array of segmented intrinsic Ge detectors with a total mass of 500 kg of Ge isotopically enriched to 86% in 76Ge. A discussion is given of background reduction by: material selection, detector segmentation, pulse shape analysis, and electro-formation of copper parts and granularity. Predictions of the experimental sensitivity are given. For an experimental running time of 10 years over the construction and operation of Majorana, a half-life sensitivity of ~4x10^27 y (neutrinoless) is predicted. This corresponds to an effective Majorana mass of the electron neutrino of ~0.03-0.04 eV, according to recent QRPA and RQRPA matrix element calculations.Comment: 10 pages, 7 figure

Variation in antibiotic prescription rates in febrile children presenting to emergency departments across Europe (MOFICHE) : A multicentre observational study

Funding Information: This project has received funding from the European Union?s Horizon 2020 research and innovation programme under grant agreement No. 668303. The Research was supported by the National Institute for Health Research Biomedical Research Centres at Imperial College London, Newcastle Hospitals NHS Foundation Trust and Newcastle University. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. For the remaining authors no sources of funding were declared. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We acknowledge all research nurses for their help in collecting data, and Anda Nagle (Riga) and the Institute of Microbiology at University Medical Centre Ljubljana for their help in collecting data on antimicrobial resistance. Members of the PERFORM consortium are listed in S11 Text. Publisher Copyright: Copyright: © 2020 Hagedoorn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background The prescription rate of antibiotics is high for febrile children visiting the emergency department (ED), contributing to antimicrobial resistance. Large studies at European EDs covering diversity in antibiotic and broad-spectrum prescriptions in all febrile children are lacking. A better understanding of variability in antibiotic prescriptions in EDs and its relation with viral or bacterial disease is essential for the development and implementation of interventions to optimise antibiotic use. As part of the PERFORM (Personalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union) project, the MOFICHE (Management and Outcome of Fever in Children in Europe) study aims to investigate variation and appropriateness of antibiotic prescription in febrile children visiting EDs in Europe. Methods and findings Between January 2017 and April 2018, data were prospectively collected on febrile children aged 0–18 years presenting to 12 EDs in 8 European countries (Austria, Germany, Greece, Latvia, the Netherlands [n = 3], Spain, Slovenia, United Kingdom [n = 3]). These EDs were based in university hospitals (n = 9) or large teaching hospitals (n = 3). Main outcomes were (1) antibiotic prescription rate; (2) the proportion of antibiotics that were broad-spectrum antibiotics; (3) the proportion of antibiotics of appropriate indication (presumed bacterial), inappropriate indication (presumed viral), or inconclusive indication (unknown bacterial/viral or other); (4) the proportion of oral antibiotics of inappropriate duration; and (5) the proportion of antibiotics that were guideline-concordant in uncomplicated urinary and upper and lower respiratory tract infections (RTIs). We determined variation of antibiotic prescription and broad-spectrum prescription by calculating standardised prescription rates using multilevel logistic regression and adjusted for general characteristics (e.g., age, sex, comorbidity, referral), disease severity (e.g., triage level, fever duration, presence of alarming signs), use and result of diagnostics, and focus and cause of infection. In this analysis of 35,650 children (median age 2.8 years, 55% male), overall antibiotic prescription rate was 31.9% (range across EDs: 22.4%–41.6%), and among those prescriptions, the broad-spectrum antibiotic prescription rate was 52.1% (range across EDs: 33.0%–90.3%). After standardisation, differences in antibiotic prescriptions ranged from 0.8 to 1.4, and the ratio between broad-spectrum and narrow-spectrum prescriptions ranged from 0.7 to 1.8 across EDs. Standardised antibiotic prescription rates varied for presumed bacterial infections (0.9 to 1.1), presumed viral infections (0.1 to 3.3), and infections of unknown cause (0.1 to 1.8). In all febrile children, antibiotic prescriptions were appropriate in 65.0% of prescriptions, inappropriate in 12.5% (range across EDs: 0.6%–29.3%), and inconclusive in 22.5% (range across EDs: 0.4%–60.8%). Prescriptions were of inappropriate duration in 20% of oral prescriptions (range across EDs: 4.4%–59.0%). Oral prescriptions were not concordant with the local guideline in 22.3% (range across EDs: 11.8%–47.3%) of prescriptions in uncomplicated RTIs and in 45.1% (range across EDs: 11.1%–100%) of prescriptions in uncomplicated urinary tract infections. A limitation of our study is that the included EDs are not representative of all febrile children attending EDs in that country. Conclusions In this study, we observed wide variation between European EDs in prescriptions of antibiotics and broad-spectrum antibiotics in febrile children. Overall, one-third of prescriptions were inappropriate or inconclusive, with marked variation between EDs. Until better diagnostics are available to accurately differentiate between bacterial and viral aetiologies, implementation of antimicrobial stewardship guidelines across Europe is necessary to limit antimicrobial resistance.publishersversionPeer reviewe

Plasma functionalized PDMS microfluidic chips: towards point-of-care capture of circulating tumor cells

The main challenge in the isolation of circulating tumor cells (CTCs) resides in their extreme rarity in blood. Here we report on the design of efficient and disposable microfluidic CTC capture devices based on the plasma functionalization of PDMS and its subsequent conjugation with the anti-epithelial-cell adhesion-molecule (EpCAM) mAb. Model studies on planar surfaces demonstrated excellent immuno-specificity of cancer-cell capture using NCI H69 small-cell lung cancer cells and SK-Br-3 breast cancer cells. Taking advantage of the transparency of the PDMS device, direct observation of the capture events on the internal 3D microstructure of the device could be achieved. At a flow rate of 16 μL min−1, an overall capture efficiency of 80 to 90% is determined in cell-spiking experiments in PBS. In accordance with direct microscopic observations, an increased flow rate (48 μL min−1) only has a minor effect (30% reduction) on cell-capture efficiency. Capture efficiency of the device using cancer cells spiked in whole blood is above 70%. The combination of soft lithography and plasma-based functionalization described in this work enables the facile fabrication of efficient and disposable CTC capture devices based on PDMS, which could facilitate the transition of this new technology into the clinical environment.Mahaveer D. Kurkuri, Fares Al-Ejeh, Jun Yan Shi, Dennis Palms, Clive Prestidge, Hans J. Griesser, Michael P. Brown and Benjamin Thierr

The Impact of Music Therapy in the Postoperative Setting on Overall Patient Satisfaction Using Validated Outcome Scores

PURPOSE: Previous studies have examined music therapy (MT) as a potential modality to relieve negative postoperative symptoms such as pain. This randomized control trial examined the use of MT on patient satisfaction in the postanesthesia care unit. DESIGN: Fifty patients undergoing outpatient orthopaedic surgery were enrolled and randomized into two groups, those receiving MT postoperatively and a control group who did not. METHODS: After hospital discharge, subjects were assessed with two validated outcome measurements for overall patient satisfaction, the visual analog satisfaction scale and the Patient Judgment of Hospital Quality survey. FINDINGS: The results showed no statistically significant differences between the MT and control group on the Patient Judgment of Hospital Quality survey (MT = 3.42, standard therapy = 3.41, P = .94) and the visual analog satisfaction scale (MT = 91.20, standard therapy = 91.65, P = .88). CONCLUSIONS: MT given in the postoperative setting has no impact on overall patient satisfaction

High-resolution in situ x-ray study of the hydrophobic gap at the water–octadecyl-trichlorosilane interface

The knowledge of the microscopic structure of water at interfaces is essential for the understanding of interfacial phenomena in numerous natural and technological environments. To study deeply buried liquid water–solid interfaces, high-energy x-ray reflectivity measurements have been performed. Silicon wafers, functionalized by a self-assembled monolayer of octadecyl-trichlorosilane, provide strongly hydrophobic substrates. We show interfacial density profiles with angstrom resolution near the solid–liquid interface of water in contact with an octadecyl-trichlorosilane layer. The experimental data provide clear evidence for the existence of a hydrophobic gap on the molecular scale with an integrated density deficit ρd = 1.1 Å g cm(−3) at the solid–water interface. In addition, measurements on the influence of gases (Ar, Xe, Kr, N(2), O(2), CO, and CO(2)) and HCl, dissolved in the water, have been performed. No effect on the hydrophobic water gap was found